Community Care of West Virginia, Inc.

NPI #1912932526 in Rock Cave, West Virginia

Provider Information

NPI Number
1912932526
Entity Type
Organization
Organization Name
Community Care of West Virginia, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Jul 11, 2006
Last Updated
Jan 18, 2024

Practice Location

Address
78 QUEENS ALLEY RD
ZIP Code
26234-5890
Phone
(304) 924-6262

Authorized Official

Name
DORA L POTASNIK
Title
CREDENTIALING COORDINATOR
Phone
(307) 317-7275

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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